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ELECTRICAL.INSPECTOR RECORD
<br />APPROVALS DATE ID/SIG.COMMENTS OWNER BUILDER DEI-CARATION
<br />I h@ry lrrh und6 p.n y ofFjury rhd I d d pr f.om thc (b.lradoR Uc@ Llw tot th. folowt{ r@n (Sd 7011.5
<br />Buins .d Prcl6rbi Cod.) ,lry Ciy or Coudy phkh EqliE . Fnit lo @irrus. .lta. 6Fotc. dc&l6lt or EFir 6y
<br />shErr Es lo ir3 islec. lLo r.quG tlE tplrlll fo. sh Fn, lo nL r r{r.d fisEl thtr lr or !h. ir li6.d FdEr
<br />ro rh. F!\!b6 ol tt! Co r*rn! l,ta.Gd t w {(1416 9. CoM*ing wht Sclim 7000 of Divitb. I of U. 0€i6 dd
<br />Pmfdiotu codc) or rhn h. or !t. a! 6oF rh6c6oo &d rh. t6s for rn dkgcd a6Fion. Any viohlioi ofsdirn 701 1.5 b, 4y
<br />lppli.d lor r Fhir ubjEr! rh. .pplic&r ro s civil pdhy of not mr. $u fiv. hu,$.d &llB {1500).
<br />l.swofrlrFlFry.aE,d'plo,6*irh*.s66rh.t$L6ot6!ba*i[&'ft.wol-dd.r.dEitol
<br />idai.d or on Ed fd ot {Sa.?Ola, B6iB 6d Proi6.io6 C6& TIE Codtuoft Li@ 13 {b6 nol t9V b e ouc ot
<br />rhc poFl, *ho b il& d in4o6 0E6r !d efio &6 sh E* him$lf or hdlf or teush hi! o, hd os oploy6,
<br />pmvlLd th.l sch irpmEEn! e d irq'd.d qofiid tr !rL.If. ho@. tlE hlildiDs or iBS.sd1d L $ld finir oE )r
<br />oforFl.ia rlr olm Ad& u ltE t& hrb! olFDvitB $n Ed,E dd mt hnu o iry!€
<br />'lE FFry 6r tlE Frrcot
<br />l. s oqr oflhc prop6rr. d .:.!6iEl, co.Ea.ring s hh ltmd conlnctoE kr cotrrNcl rlE Fojc.l (5<. 7044, tt{in4
<br />!n Eollid Co&, Tnc Contdol! ticru L.r d.6 ml $ply lo 6 oM6 o I proFr, who tEildr or impb6 $don.
<br />.Id who smxt! fn *t Fj.it! *nn . Cod'aro(., li.al!.d F6d ro rlE Co' rrlq t L{qg t *)
<br />I m .tmpl und6 56l nn-
<br />Drrc_ _ _ Oind:_
<br />woRxnq.coMpNs TIoN
<br />DECtdSAr.tA!
<br />I lErty lllun un& pqdry olFJGy or olrh. t oowiq d..la.tioM
<br />.lh!r.adw,ll@i.in.Cclifrd.of(lrnsrl.S.laJnu.formrt6odp6!r.io'!ap.!vid.dforbysarionl70OoallE
<br />I.bn Cod., fd rlE Ffm. of rh. $ul ld "tth llE Fnn ir isu.d.
<br />X uvc ra qitt minun *od6 conrEs.riotr iBu,ec.. s rqon.d b, sdhn l7m oa$. L.bor cod.. tor tlE Frolllm. or
<br />rh. work for wh,chrh! Domrl i3 su.d Myworld onFsd'o. iBurk.ffi! polic) numba e.*, -kdetat -ArrSrrc"ce fO
<br />,",*r*,.n-, 54.?OQl"6}-- ..r,-, t'al'Jb3D
<br />._l .drit 'h.l in $. Ffol11r,m of th. sort f.r *hi.h lhis Fnn ir isud. I tlltl! el a,ploy x, F$n in 6y .rm
<br />s 6 ro tEor sbjcr ro llE s*d'6mF!.i,o L{. otcrhfomi !i {E rl{ ial ilDuld baor sDjcl lo lll
<br />Ed6' @nF!.rb. FovrEB oasdh.l?m ofrlE t tor Codq I trll ftnltrni oqrly vid rho. F.vitioB..
<br />*ARNIN(i ,!ilur. ro <uc *orkd'
<br />cnil fin6 up ro 06 hun&.d rhous,ld
<br />lidrfn 1076 ofrh.lrh cdla iddd
<br />,.,.,I.3l.JDeo
<br />cor{Es6rion ovd!. n uf,h*ful. ed lrdl rubj.q m @rloyr lo simi.tl Ftrtk sd
<br />tl.ll,E (lt00,o0o). in.ddnir. ro rh. con of coEFBrn',i. d.,t,86 a Forilal for rh.
<br />r fdr^ \ ^\'\'l[:\, Nt-
<br />r rt r--FsEf,<rr r n ri 'F-l
<br />Df(.t rl{\'t l()\
<br />I hz$, dIm ur& Frhy of Frury rhr I d liEr..d uidE Foviraon of Ct4rE 9 (@tr:Mtr{ enn SErbE 70@) of Dnirbt l
<br />of rlE ButB dd PrcadioB Cod., td ny ltog i! in tull lottod .fli.l
<br />Cto \b4'*- lJr.f,oC{)
<br />ca!flf,llcuorLEdDAclcEurr
<br />I td!b, Jtm utib Fdy of Fju.y Or rhd. ir . @irndn{ bdilg l8dy tu llr Ffdffi oillE wl 6, xli.h lni FDi !
<br />qq.d (56 1097.civ.c.).
<br />ATSJCANTDESJEAIqX
<br />I ho&, lmmt undd F.lr, olFJury o..of rh. aolloeing dcladioN:
<br />Ddmhion Pdfinr'Arbdo MlifE.rn! l.dqrt R.suLlioB (Tn|.40, Pd6)
<br />R.qun.d L.rla ol rJorifi.lbn
<br />!d Counry ro ard l4o lt
<br />!B!:JDCD
<br />,*u- -'. ,rn"u''--l DAa
<br />Site-Work
<br />Underground
<br />Pole Bases
<br />Lioht Standards
<br />Spas, Pool, Fountains
<br />Sions (monument)
<br />Life Safety /Low Voltage
<br />Fire Alarm / Dampers
<br />Building
<br />Under Slab / Floor
<br />Bonding / Grounding / UFER t lztlz.s Dkr)ot--+ls-q
<br />Transformers rl
<br />Torqueing
<br />Sub-Panels
<br />Air Conditioners
<br />Roof Top Equipment
<br />Factory Wired Unit
<br />Walls (Conduit)
<br />Walls (Rouqh)
<br />Ceilinqs (Hard & Soffit Rouqh
<br />Ceilings (T-Bar Rouqh)
<br />Meter Release t12?l?-o P+il)€,-4fl
<br />Rough
<br />Service l\,4eter ll'24 l'z{)PWa z# 8? - -fqnO Port t-
<br />FINAL tla.4'11-o Dtrvtc LTLET
<br />Notes, Remarks, Etc
<br />ei
<br />Rev.08"07-2015
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